Adenium

Sadly the primary pay was about $70k, not $100k. I paid out of pocket at a state school and spent plenty. Wanted to recoup some and start real retirement savings. With the DNP push NPs' education will be even less cost effective The powers that be seem too focused on educational quantity over quality.

Just keep in mind there are reasons why MDs and PAs and often many NPs are choosing specialties over primary care......you need to know a fair amount about a lot of things, see many patients in a day in short time slots, and you generally get compensated less. I would have loved to take the primary care spot I was offered, but when I was offered at least $35K more elsewhere plus better schedule and benefits it was tough to justify.

If it was an office where I interacted with a lot of the MAs, secretary etc I brought in Dunkin Donuts or baked goodies or got a big Edible Arrangement. If it was really just the preceptor, I got a gift card for places they liked (Dunkin etc.) or a smaller Edible Arrangement. Also a nice thank you card telling why they'd been so helpful. My school gave no compensation, so I felt like they deserved something nice. Oddly, two preceptors gave ME a card and gifts. It was a little funny, and I'd have felt horrible not having anything for them! Not everyone did preceptor gifts when I asked my classmates.

It is actually possible to get AANP approval quite early. I had my authorization to test within a week of finishing....the AANP lets you send in an application with an official transcript prior to completion of the program - it just has to show progress up to that point. You can't actually TEST until you've graduated and sent your final transcript, but they can have the app ready to go. You're supposed to get their letter and then Prometric approval a week later, but they came within a day or two of each other for me. The early birds get processed much faster, before the onslaught of May grads. You can apply up to 6 months before graduation. I waited to test so I could take the Fitzgerald review and study for 6 weeks, but I certainly could have tested much earlier if I'd felt ready. Confidence-wise, I needed the study time. In reality, I probably would have passed anyway as I felt like the exam had a LOT of things I'd never seen in a review book as well as some things that were very basic and that I'd known from prior coursework. At a level of gee what electrolyte would you check a week after starting an ACE inhibitor....but obviously I wasn't taking chances with something so important and a job waiting.

The AANP will send a letter with your score and a listing of categories like planning or diagnosis or evaluation that really aren't helpful at all. Mine listed from strongest to weakest. Did you start your reapplication and CEs, or are you going to try ANCC instead? I think the Leik book is a good idea. I would also suggest either the APEA/Hollier Qbank or book of questions. For me, that was the most similar to the exam, but many people say Leik is very close as well. It just doesn't give you as many questions. I had the APEA book only - they told me when I called that buying the Qbank or predictor tests would really give me the same questions. I found them helpful, though yes there will likely still be things on the exam that you don't recognize and haven't seen in a review. I think they plan it to be that way, and expect you'll have to make your best guess or a well-reasoned answer. Maybe you just had bad luck in the mix of questions that particular day, and happened to have more that you didn't happen to be familiar with. I'm not sure how much they vary from one exam to the next, but hopefully the next one will be it.

Sorry to hear that! Did you feel there was anything in particular that was tougher? In any case the letter from AANP will only give you vague categories for weak areas like assessment/planning/evaluation so if you want to retake AANP I'd just get started on the 15 CE credits or whatever they require. Were you able to get thru the study materials you had? I didn't have time for Leik but it's highly recommended. Did you feel when you were going thru questions that you understood the rationales or why they selected the right answer? I know it must be discouraging but that doesn't mean you won't be successful on a second try. If you felt up to studying research/ethics/theory you could register for ANCC and see if that exam style works better for you.

So true Cardiac-RN. I'm so excited to have 4 weeks vacation and actually have a prayer of taking time! With the hospital it was always such a coverage issue - most of us just had to give up some of our PTO because it didn't roll over and we couldn't get a chance to take it.

Good point elkpark. I have heard of that happening with some schools - my own happens to view PhD and DNP as adequate. My MSN professors were required to get the DNP if they didn't have it already.

I did not take a pay cut, in fact I got a decent jump in pay, but I joined a large organization that could afford to pay well. The primary care office I interviewed at gave me a very low offer (close to RN pay, though with added productivity bonus after a year and with excellent mentorship). I was a hospital nurse for 5 years, worked some of the time as rotating shift, some as night-shift, most as day-shift. Every other weekend, every other holiday. So I wasn't earning poorly but not pulling in 6 figures either. I did not choose to do overtime, and that was a limited option at my hospital anyway. I have classmates that did a combo of per diem jobs, or worked as nurse coordinators, etc. who did get similar pay as NPs or sometimes slightly less than they has as RNs. They were willing to bite the bullet to get good experience, knowing they'll get higher pay down the road. For me, even if I'd been offered less, I'd have taken it. My back pain was getting terrible from Q2hr turns, and I was sick of using my body all the time instead of my mind. My husband hated the weekends and my family hated the holidays. It's worth it for me to be done with that, though there are nursing jobs away from bedside if the physical labor is the only concern. Everyone has to look at what's available in their market and decide if it's worth it to them. There are plenty of better ways to make money than being an NP, but no one need fear starving if they become one. I'm not sure what will happen in the future as there will likely be a fairly saturated market, but it will continue to vary geographically as it does now.

My school was one of those that went to DNP-only and ended up switching back - there's just not enough interest as it means more time and money spent getting the degree, but no better clinical preparation or difference in pay. When I went looking for jobs, no employer seemed to know anything about DNP vs MSN or to care what degree I had. They were only concerned with employment background and clinical preparation, along with (obviously) my licensing status as an APRN. The only thing that gives me pause is that I'd like to teach one day, preferably at the graduate level. That will require a doctorate, and I'd thus be excluded. But that would be well down the road, after I'm experienced, and if I need a DNP at that point I'll look at the reimbursement options. I also think I'd be better prepared for the research projects involved once I've been in practice. If I were to do it now, I'd have no idea what direction to go. How can I have an area of practice I'd passionately like to improve before I've actually been a practitioner? I'm sure I could do it, but it'd be a long arduous road and I need to be certain where it will take me first. I'd suggest identifying where you'd like to work, and talk to some folks in those places or shadow. Find out what they're looking for in hiring, now and into the future. Also talk to program directors at schools you're interested in, and see if they have plans to switch. However, if you start an MSN program they shouldn't be able to change the rules partway through the process.

I found going thru APEA sample questions to be the easiest/most helpful thing to do as I got close to the exam. It was more pleasant to do that than try to reread study material which got harder and harder to concentrate on. That and looking over abx tables for common conditions which I had trouble memorizing. Flashcards of stuff I kept forgetting too. Just know you'll probably see some questions on things you aren't familiar with, but that it's OK. I was afraid I'd fail if I didn't know everything in the review books but I passed anyway.

I'm in CT, I would think OH would have something similar?

I graduated in May and am lining all this up now though it may vary a little by state. Passed AANP 2 weeks ago but waiting on my letter. The state DPH site lays out required steps...mine requires an application with passport photo, bank check, transcript directly from the school, verification form for pharmacology hours from school, and the letter from AANP. So, boards are first, though I have classmates that submitted their state APRN applications before they had written confirmation of passing boards. Once you get your state license you can proceed. NPI asks for an employment site and I think DEA may as well. For my state you need state drug license before federal. I start my job in a couple weeks so they'll help with some of this. You'd think schools would help more with this...we had to did a final project outlining steps but it was still murky and it would have been nicer to just get a list of steps from people who'd recently done it!

You will get there! Keep at it and good luck. Soon it will be in your rearview mirror.....

I always kept an NSO policy as an RN, and I think I'll probably get one as an NP as well. Yes my employer will cover malpractice, but I think you need someone really covering YOU and your interests. When I looked at the basic policy it cost about $1200/year.

I read Ativan's post and felt like I was reading my own thoughts from a few years ago. I did well going into nursing, moved up into stepdown then ICU, but always felt anxious....waiting for the %$ to hit the fan. I felt like I was already invested in the career path and went to NP school, but now that I'm looking at the stress of a new role I sometimes think it might have been good to try non-hospital areas. When I did clinicals in a pulmonary clinic, there were nurses there who just gave shots and did patient education. Regular schedule, predictability, low stress. I was a little jealous! I think you need to look at what aspects of the job make you nervous and then figure out what jobs might present fewer of those triggers. For me, I need predictability and hope to eventually have some of it as an NP. I know what you mean about critical care being seen as a bad-ass pinnacle....such bull. I could do it but didn't enjoy it as I hoped, and that's OK. As I've gotten older I've learned it's more about what fits me and my life and goals, not what looks cool or accomplished. The happiest I've ever been was working a customer service job at a great company as a temp. Had tons of energy outside of work, really lived life to the fullest then. I left that job to go back into an arena I thought should be more fulfilling and suited to my schooling. Ha ha.

That would never happen on these boards . I do find the APRN section to be decent about this, though. Good points - and smart to realize we can't really predict perfectly. Everyone has to look at the factors involved and make an educated guess for their geographic area or look where they might be able to relocate. And yes, once you're experienced it'll be a little different (as with RN jobs). One thing about primary care, where the projected demand is - the hands down worst offer I received was from a private primary office. There may be a need, but that doesn't mean people can/will pay for it. There's a reason many MDs have avoided primary: it's hard to make money and yet you're responsible for knowing a decent amount about everything that might walk in the door. I think some practices are perfectly happy to try to use an NP to make more money, but that NP may be subjected to the same productivity requirements without reaping the same benefits. I didn't expect much above my nursing hourly wage, but I was floored by what was offered. And I was a nurse for 5 years - not comparing to working nights/weekends/20 years experience. If that had been the only job around I would have been really upset. Great opportunity to learn, docs that really seemed to like me, but wow am I happy I had other options. Because I want to retire while I can still hobble around and enjoy it! I'm still happy I went back to school, but if I were looking at starting now I'd be networking like crazy and trying to get a real gauge of the local market. And I'd want to be darn sure being an NP was what I really wanted vs. just moving to a different arena as an RN.

If you poke around in the APRN section here and/or do a search on master's vs. DNP you'll find more than you ever wanted to read on the varied opinions. In short, you do still have an option as nursing is a slow-moving beast. The states are not really moving towards requiring DNP, thus all the huffing and puffing from the ivory tower doesn't mean much. You may need/want DNP in the future, and if it's feasible now you might consider it. I almost lost the option as the programs near me went to DNP only, but that fell flat as their admissions dropped off and they went scrambling back to offering an MSN. I may go back later if I need to and if someone pays me for it, but for now I'm VERY glad to be out working and gaining experience and earning money. DNP would have meant extra time and tuition, and no extra edge when going for a clinical position. They only door it would open is the chance to teach at the Master's level, which I don't need yet. At most schools DNP will mean more work on research and application of research/health policy - not extra clinical preparation. It's closer to a PhD in nursing than I'd like it to be - I have zero interest in working in research. In any case, finish your BSN and do some shadowing, decide what track you want (Acute, Adult, Family etc) and pick what school works best in terms of tuition, location, clinical support, etc. Then do what you need to get admitted.

Just looking at your list, that's a very very ambitious plan and likely too much to get through. I left myself 6 weeks after graduation to attend the Fitzgerald course and study that workbook, her published book, and Hollier's book of questions. By the time the test was a week away, I felt burnt out - like I didn't know everything but just didn't have it in me to study more. I didn't even finish going through everything. If I'd dipped back into my school texts I would have driven myself insane. Most of the review courses will suggest limiting yourself to a few sources to avoid going crazy and to leave room for what you're trying to cement in your brain. I would bet if you go through Fitzgerald, Leik, and Hollier you will be fine. Everyone I know this year used those sources or less and passed, some people took both AANP and ANCC and passed. I would start with the review books, and only look up more details on things you really feel weak in or don't understand. If you have extra time and energy, maybe go further, but make sure you cover at least one review book thoroughly and do lots of questions. I've seen such mixed reviews on the exam edge/familynpprep.com tests that I didn't spend my money there. I felt Hollier's book of questions was decent prep and similar to exam questions - there are some errors but I could spot them and the rationales for each question were decent. Trust in what you've done to prepare. You don't need to know everything about everything to pass - the boards are for entry-level competency.

I live in the Northeast, which seems to have a better market than places like Florida, but I do worry the market is becoming more saturated. I was lucky and got a job within a month of graduating (and had multiple places interested) but not all classmates have found positions. And some of the offers were ones I really didn't want to have to take - after all that work and with all the extra responsibility you don't want to be in a begging position taking whatever is left over. It is a big worry that even brick-and-mortar schools like mine are just ramping up their admissions. I graduated with a couple dozen other ANP/FNPs.....graduating classes used to be 8-10. In my first year, we had over 40 people in our Pathophys class and there weren't even chairs for everyone. Every term it was a struggle to find clinical preceptors, because the school had overadmitted and outstripped the local resources. This was a problem for the last 3 years and yet they're still admitting large numbers. Then we come out in May along with all the other local schools, and compete for what's out there. Not a sustainable system in my view. To avoid this problem and to be seen as more professional, I do think there should be national limits on the number of schools and graduates as many other fields have. If you look at basic supply and demand, you run into trouble by endlessly increasing supply. I feel like I went back to school and got a job just in time, but I still worry for the future. The schools, however, will continue to push for more RNs and more NPs and talk about a shortage til they're blue in the face. They love that tuition money, and it just keeps going up.

Congrats! It's the best feeling, right? It seems to be a recurring theme that you can't let yourself get rattled. Fitzgerald talked about this in her live course as well - she mentioned they often have tougher questions at the beginning and you need to just pick an answer, mark it and move on. You can always come back, but you might really psych yourself out staring at it for 2 minutes waiting for an epiphany. I moved on to easier questions and felt a lot better, and ended up changing none of the answers.

I interviewed with Minute Clinic (preliminary round with a recruiter, very low-key and easy) and they said I'd be able to shadow before accepting an offer. The schedule would be every other weekend, alternating hours per week, so Week 1 you do three 10-hr shifts and Week 2 you do two shifts during the week and then also work both Saturday and Sunday. Orientation was being expanded from something like 6-9 days to more like 2 weeks based on trainee feedback. There's no one else there with you afterwards but you'd be able to call your clinical manager with questions. I was offered an interview with the local manager, but took a different job. I was happy to get away from working weekends, however it's a great option for some people particularly balancing kids' schedules. I did worry a bit about performance incentives and patient satisfaction (the dreaded "she's horrible because clearly I needed abx and she didn't give them to me") but they said they're aware of that issue and working to maybe change the evaluation system. It did sound like their current system is based on patient numbers and Press-Ganey style surveys. I would clarify that with whatever group you interview for. Good luck!

All my classmates have been passing AANP and ANCC but I don't think any of us felt ready or confident. Remember you can get many questions wrong but still pass. Don't let it throw you. Read the questions carefully and trust your schooling and all that prep you did. Good luck!! Go rock that exam!

Since I read this board quite often leading up to my exam and got worried seeing a lot of board failures, I figured we need a more recent posting of success too. I know when I was reading I wanted to see what worked for people taking boards thru AANP and who had done it recently. I took the FNP exam Monday, roughly 6 weeks after taking the live Fitzgerald review. The course was helpful, but you certainly need to leave time after it to really read thru the tables in the workbook, go through the online lectures and PDFs, and digest everything. After the course I went through ALL of Fitzgerald's older certification review book and went back through most of the review course workbook. I did listen to all of the online lectures except for the ones on ethics (since that's geared more towards ANCC prep), and at least skimmed all the extra materials. Meant to review Bates but ran out of time. What I found really helpful too was APEA/Hollier's book of 1300 or so questions with rationales. There are errors (as there are in all prep materials) but it was good practice. I was going to buy the online question bank or predictor tests, but when I called they said there wouldn't be any difference in the questions if I already had the book. I paid for the AANP sample exam too, which says you need a minimum of 66% to "pass" but that you should really get at least a 75% to give some leeway. I got 85% on that, and 91% on Fitzgerald's sample test in her online materials. That made me feel a bit better. Almost bought tests from familynpprep.com but I'm glad I didn't spend the extra money. There's only so much you can do to prepare! In the exam itself, there were a number of things I didn't have any idea on but it wasn't because I hadn't reviewed well enough. They throw some weird things in there, that aren't in any review book. But, with the way they score it (needing 500/800) you can still pass despite having to guess on a lot of questions. It helped to remind myself of that as I went through and tried to ignore my pounding heart. And I'm glad I reviewed a lot of peds and maternity, as that was a hefty component it seemed. Fitzgerald said the questions would be mostly about well children - I didn't find that to be the case. And while there was some worry about whether we'd have issues straddling the time period between JNC7 and JNC8 being incorporated, that wasn't an issue. Today (2 days post exam) my certification number already shows up on the AANP website. :) I'm a happy woman. So for all those still prepping and freaking out, don't go nuts and spread yourself too thin trying to review a million different sources. Pick one or two things, be diligent and attack them piece by piece, and go through the exam slowly and carefully. You'll likely see things that throw you - mark them and come back rather than sitting and stewing over them. Remember that postings here may skew towards those who didn't pass, as they're understandably upset and looking for help and reassurance. I terrified myself reading these boards leading up to the test. Good luck to everyone testing or retesting!

Good luck to you. Keep that feeling of excitement that you have in anticipation - you'll need to recall it later to carry you through. You can do it!